Compassion fatigue in nurses: A metasynthesis

Bracing for the next wave: A critical incident study of frontline decision-making, adaptation and learning in ambulance care during COVID-19

AIM

To explore frontline decision-making, adaptation, and learning in ambulance care during the evolving COVID-19 pandemic.

DESIGN

Descriptive and interpretative qualitative study.

METHODS

Twenty-eight registered nurses from the Swedish ambulance services described 56 critical incidents during the COVID-19 pandemic through free-text questionnaires. The material was analysed using the Critical Incident Technique and Interpretive Description through the lens of potential for resilient performance.

RESULTS

The findings were synthesized into four themes: 'Navigating uncharted waters under never-ending pressure', 'Balancing on the brink of an abyss', 'Sacrificing the few to save the many' and 'Bracing for the next wave'. Frontline decision-making during a pandemic contribute to ethical dilemmas while necessitating difficult prioritizations to adapt and respond to limited resources. Learning was manifested through effective information sharing and the identification of successful adaptations as compared to maladaptations.

CONCLUSIONS

During pandemics or under other extreme conditions, decisions must be made promptly, even amidst emerging chaos, potentially necessitating the use of untested methods and ad-hoc solutions due to initial lack of knowledge and guidelines. Within ambulance care, dynamic leadership becomes imperative, combining autonomous frontline decision-making with support from management. Strengthening ethical competence and fostering ethical discourse may enhance confidence in decision-making, particularly under ethically challenging circumstances.

IMPACT

Performance under extreme conditions can elevate the risk of suboptimal decision-making and adverse outcomes, with older adults being especially vulnerable. Thus, requiring targeted decision support and interventions. Enhancing patient safety in ambulance care during such conditions demands active participation and governance from management, along with decision support and guidelines. Vertical communication and collaboration between management and frontline professionals are essential to ensure that critical information, guidelines, and resources are effectively disseminated and implemented. Further research is needed into management and leadership in ambulance care, alongside the ethical challenges in frontline decision-making under extreme conditions.

REPORTING METHOD

Findings are reported per consolidated criteria for reporting qualitative research (COREQ).

PATIENT OR PUBLIC CONTRIBUTION

No Patient or Public Contribution.

Person-centred care and online pedagogy in nursing education: a discussion paper

AIM

To discuss person-centred care in nursing education and the role of online pedagogy to facilitate meaninful learning.

BACKGROUND

The core principles and values of person-centred care are at the centre of national and international healthcare education. Person-centred care recognises partnerships and relationships between nurses, healthcare practitioners and individual patients, carers and their families and part of the training of healthcare professionals. However, the literature on how person-centred care is taught to facilitate meaningful learning in nursing education particularly in the context of online pedagogy is limited.

DESIGN

A critical discussion paper.

METHODS

A critical discussion of person-centred care and online pedagogy that can facilitate teaching practices are presented, drawing on authors' positionality and case exemplars.

RESULTS

Teaching person-centred care using online pedagogy appears to have a promising impact on undergraduate and postgraduate nursing students' experiences. Engaging students in critical examination and reflection on the complexities of person-centred care in practice creates meaningful experiential learning for both students and educators.

CONCLUSION

Evidence suggests that the use of online pedagogy is a beneficial and effective way to incorporate the teaching of person-centred care into nursing education, yet more evidence is needed to evaluate its impact on nursing practice.

What determinants impact deceased organ donation consent in the adult intensive care unit? An integrative review exploring the perspectives of staff and families

BACKGROUND

Deceased organ donation saves lives. Donation processes in New Zealand operate under an opt-in system, which requires consent from families of patients diagnosed with brain death or circulatory death while in the intensivecare unit. The donation demand and supply mismatch is a global phenomenon.

OBJECTIVES

The objective of this study was to understand the determinants of deceased organ donation decisions in the adult intensive care setting from the perspectives of staff and families.

METHODS

An integrative review based on Whittemore and Knafl's approach searched literature through databases CINAHL Plus, SCOPUS, Proquest Medline Ovid, and manual ancestry searches. Inclusion/exclusion criteria screened for pertinent literature, which were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Selected studies were appraised using a generic scoring tool, and data were systematically extracted and coded onto spreadsheets using inductive, thematic analysis.

RESULTS

A total of 21 studies (12 qualitative, seven quantitative, two mixed methods) were included. Publication dates ranged from 1993 to 2021 from multiple countries (18 opt-in, three opt-out systems). Four overarching themes pertaining to families and staff were generated. Important knowledge related to families' knowledge deficits around brain death, the purpose of ventilation, donation procedures, patients' wishes, and staffs' lack of training. Challenging communication highlighted miscommunications due to language choices and interrupted continuity of care during staff-family interactions. Internal determinants explored the cultural, spiritual, and emotional perspectives of families, while staff faced a sense of burden and conflicting values in delivering care between donors and recipients. External determinants related to the clinical environment impacting on grieving families, while for the staff, it explained concerns around resources and organisational processes.

CONCLUSIONS

Factors underpinning deceased organ donation are multifaceted and complex. Staff actions and families' decisions are inextricably intertwined. Modifiable factors include a lack of formal training and communicational skills and environmental limitations of an intensive care setting.

Compassion Fatigue: A Comprehensive Discussion on its Development and Repercussions Among Oncology Nurses

OBJECTIVES

This study aimed to discuss how compassion fatigue (CF) develops and its repercussions on the personal and professional lives of oncology nurses.

METHODS

A discursive article, with systematic searches were performed in seven databases to find publications on CF in oncology nurses.

RESULTS

So as to better organize the findings, three categories were developed to present and discuss issues related to CF: (1) Characteristics of CF and its developments: describes the components related to CF and the manifestation of this phenomenon; (2) Repercussions of compassion fatigue: reports on the impact of CF on the personal and professional life of oncology nurses; and (3) Resources for dealing with compassion fatigue: lists interventions, sources of support, professional personal training, qualified nursing care in the face of adversity, and gratitude and recognition.

CONCLUSION

the factors that trigger or protect CF are multifactorial, with the need for collective and individual interventions as a way of helping oncology nurses to protect themselves, to avoid or manage this phenomenon. CF has a direct clinical impact on the life of the oncology nurse, causing several changes. It also indirectly impacts the patient's life clinically, as it is a phenomenon that has repercussions on the provision of care.

IMPLICATIONS FOR NURSING PRACTICE

CF affects the personal and professional lives of oncology nurses, so nurses need to seek resources to deal with it. Nursing staff employers and managers can use the evidence from this research to help nurses manage and protect themselves from compassion fatigue.

Contributors to fatigue among nurses working in critical care units: A qualitative study

BACKGROUND

Fatigue is a growing concern among nurses who provide care to unstable and critically ill patients in critical care wards. It has various negative consequences for both nurses and patients.

AIM

To explore and describe contributors to fatigue among nurses working in critical care units.

STUDY DESIGN

A qualitative content analysis.

RESULTS

Participants were 21 nurses chosen using purposeful sampling. They were working in different critical care units at different hospitals in nine urban areas of Iran. Semi-structured interviews were used to collect data, and conventional content analysis was used to develop categories and subcategories. The analysis of data on the nurses' perspectives and experiences led to developing nine categories as contributors to fatigue: 'compassion fatigue', 'extensive network of interactions', 'sound and alarm fatigue', 'psychological tensions', 'managerial and organizational tensions', 'lack of motivation and incentives', 'individual characteristics of nurses', 'physical and mental pressure', and requirements of special care and situational complexity'.

CONCLUSIONS

Understanding the factors that influence the experience of fatigue among nurses working in critical care units is essential for maintaining a reliable and high-quality health care environment within health care facilities.

RELEVANCE TO CLINICAL PRACTICE

The experience of fatigue by critical care nurses can increase the possibility of practice errors, reduce patient safety and quality of care, and enhance staff burnout and turnover. Proactive policies should be formulated to assess nurses' fatigue levels and implement strategies for effective fatigue management. This approach aims to enhance both patient safety and job satisfaction in the workplace.

The impact of prior care experience on nursing students' compassionate values and behaviours: A mixed methods study

BACKGROUND

Compassion is critical to the provision of high-quality healthcare and is foregrounded internationally as an issue of contemporary concern. Paid care experience prior to nurse training has been suggested as a potential means of improving compassion, which has been characterised by the values and behaviours of care, compassion, competence, communication, courage, and commitment. There is however a dearth of evidence to support the effectiveness of prior care experience as a means of improving compassion in nursing.

OBJECTIVE

To explore the impact of paid prior care experience on the values and behaviours of pre-registration nursing students indicated as characterising compassionate care.

DESIGN

Longitudinal mixed methods design employing a modified concurrent triangulation strategy, comprising two work packages. Work package 1 was qualitative, and work package 2 adopted a concurrent embedded strategy with a dominant quantitative component. Research is reported in accordance with the Good Reporting of a Mixed Methods Study framework.

SETTING(S)

Three United Kingdom universities.

PARTICIPANTS

Pre-registration nursing students attending one of three universities, and individuals who had previously participated in a Health Education England paid prior care experience pilot. Participant numbers at time point 1 were questionnaires n = 220, telephone interviews n = 10, and focus groups n = 8.

METHODS

Work package 1 consisted of longitudinal semi-structured telephone interviews. Work package 2 comprised validated online questionnaires measuring emotional intelligence, compassion satisfaction and fatigue, resilience, psychological empowerment, and career commitment (as proxies of compassionate values and behaviours), and focus groups. Qualitative data were thematically analysed. Quantitative data were analysed via Analysis of Variance in SPSS v 26.

RESULTS

Qualitative findings suggest that prior care experience has both positive and negative effects on students' compassionate values and behaviours, however positive effects do not extend to qualification. No statistically significant differences were found in any of the quantitative outcome measures between participants with and without paid prior care experience. A statistically significant increase in compassion fatigue was identified in both groups of participants post-qualification. Paid prior care experience did not prevent participants from experiencing reality shock on becoming a student or on qualification.

CONCLUSIONS

There is insufficient evidence of longitudinal beneficial impact to recommend paid prior care experience as an effective intervention to foster nursing students' compassionate values and behaviours. These findings do not support mandating a period of paid care experience as a prerequisite for entry into nurse education.

REGISTRATION

N/A. Tweetable abstract Insufficient evidence of longitudinal beneficial impact to recommend prior care experience as an effective intervention to foster nursing student compassion @PriorCareExp @Sarah_F_R.

The Partial Mediator Role of Satisficing Decision-Making Style Between Trait Emotional Intelligence and Compassion Fatigue in Healthcare Professionals

Background: Compassion fatigue (CF) represents a relevant issue for healthcare professionals. Currently, it is still unclear which psychological mechanism might lead to CF and which might protect workers from that. Decision-making styles, as well as emotional intelligence, might partially account for the presence of CF. Specifically, we hypothesized that a satisficing decision-making style would mediate the relationship between emotional intelligence and CF.Methods: A cross-sectional online survey was conducted on physicians and nurses from Italian Medical Departments. Three self-reported questionnaires were administered to collect data in accordance with our aims. A mediation model with Structural Equation Modeling on the relationship between trait emotional intelligence (TEI) and CF through the maximizing decision-making style was performed.Results: We found a significant relationship between TEI and CF (β = -0.28, SE = 0.04, p < .001). The maximizing style partially mediated this relationship (β = -0.04, SE = 0.01, p < .001). Moreover, negative relationships were found between sex (male), working hours, sleep quality, and CF. Conversely, a positive relationship between age and CF was demonstrated.Conclusions: Being emotionally intelligent resulted as a protective factor for developing CF, while the decision-making styles shaped the risk of developing CF.

Factors affecting nurses' compassion fatigue: A path analysis study

BACKGROUND

Nurses often experience compassion fatigue as a result of exposure to chronic work-related stress. It is thought that nurses' mindfulness levels and patience attitudes might be effective on compassion fatigue.

AIM

Therefore, in this study, it is aimed to examine the relationship between nurses' compassion fatigue, mindfulness levels and patience levels.

METHODS

The study was carried out in a descriptive and relation-seeking type and was completed with the participation of 469 nurses. Data Form of Demographic and Professional Characteristics, Compassion Fatigue-Short Scale, Mindful Attention Awareness Scale and The Patience Scale were used as data collection tools.

FINDINGS

As a result of the research, it was determined that there was a relationship between the mindfulness and patience levels of nurses and compassion fatigue. As the mindfulness and patience levels of nurses increase, compassion fatigue decreases (p < 0.05). As the mindfulness levels of the nurses increase, their patience levels increase as well (p < 0.05).

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

Accordingly, it is recommended to increase the level of patience and reduce compassion fatigue by applying interventions that will increase the mindfulness levels of nurses.

Trauma Registry Professionals' Perspectives on the Secondary Traumatic Stress Component of Compassion Fatigue: A Qualitative Study

BACKGROUND

Secondary traumatic stress and compassion fatigue have been studied among trauma clinicians yet have not been explored in trauma registry professionals (TRPs).

OBJECTIVE

The purpose of this study is to describe the secondary traumatic stress component of compassion fatigue among TRPs.

METHODS

A qualitative, phenomenological study was conducted to examine TRPs' experiences with the secondary traumatic stress component of compassion fatigue. The primary investigator assembled a multidisciplinary team of researchers, including nursing leadership, registry educators, mental health experts, and qualitative researchers. Two focus groups were held virtually in January 2021, using an interview guide designed by the research team. Participants were recruited via an email sent to a list of colleagues known to the research team from training classes held nationally and selected for their diverse clinical experiences, years in the role, demographic background, and trauma center representation. The recorded sessions were independently transcribed and analyzed by a five-member subgroup of the research team; the analysis concluded in December 2022.

RESULTS

Nine TRPs participated in the focus groups. Participants came from Level I, II, and III adult and pediatric trauma centers and military centers. Four themes emerged from the data: disquieting and rewarding work, reactions and emotional responses, the influence of personal histories and background, and coping strategies.

CONCLUSION

A qualitative analysis of focus group discussions revealed the secondary traumatic stress component of compassion fatigue is present in the TRP.

Unveiling the burden of compassion fatigue in nurses

BACKGROUND

The COVID-19 pandemic has placed an unprecedented burden on nurses who have been at the forefront of patient care. The continuous exposure to suffering, death, and overwhelming demands has the potential to lead to compassion fatigue, a state of emotional, physical, and cognitive exhaustion.

RESEARCH AIM

The study aimed to explore and understand the phenomenon of compassion fatigue in nurses as the effect of the COVID-19 pandemic.

RESEARCH DESIGN

A constructivist grounded theory design was used.

PARTICIPANTS AND RESEARCH CONTEXT

The research data were collected from 20 nurses who had been employed in pandemic clinics in Turkey for a minimum of 6 months. Data were collected using a two-step approach: purposeful sample selection followed by theoretical sample selection. Individual interviews were conducted via an online platform with participants who consented to participate in the study from January 16th to April 28th, 2022. The collected data underwent initial, focused, and theoretical coding for analysis. The research findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines.

ETHICAL CONSIDERATIONS

Ethical approval for the study was received from Non-Interventional Clinical Research Ethics Committee. The study was conducted following the Declaration of Helsinki.

FINDINGS

The study identified a core category, namely the desire to provide the best care, which was accompanied by five main categories: causes, symptoms, consequences, coping methods, and the benefits of coping methods.

CONCLUSION

During the pandemic process, nurses have experienced compassion fatigue due to various factors and have seen its symptoms. Nurses have developed various coping mechanisms individually. However, they have not indicated any institutional-level support. It has become necessary to plan nurse-centered comprehensive interventions that will reduce compassion fatigue.

[Impact of care for victims of gender violence on the health professionals]

Professionals who work with women victims of gender violence face difficult emotional situations, and it is important to be aware of the emotions and feelings that the attitudes and behaviour of victims and aggressors generate in them. These emotions can become barriers to communication and seriously affect the professional's relationship with victims. Furthermore, they can generate situations of sustained stress, lead to emotional exhaustion, and affect their health, life, and work performance. We describe the consequences, risk factors and warning signs, as well as protective or resilience factors, that are important to know, and we list the current challenges and some recommendations for professionals and management in order to help prevent such effects and improve professional performance without health risks.

Areas of work-life, psychological capital and emotional intelligence on compassion fatigue and compassion satisfaction among nurses: A cross-sectional study

AIM

To examine the impact of six areas of work-life, emotional intelligence and psychological capital on compassion fatigue and compassion satisfaction among Canadian Registered Nurses and licensed practical nurses.

DESIGN

A cross-sectional survey study.

METHODS

A convenience sample of 296 Registered Nurses and 110 licensed practical nurses answered a self-administered questionnaire measuring areas of work-life, psychological capital, emotional intelligence, compassion satisfaction and compassion fatigue in September 2019. The association between variables were analysed with descriptive and correlational analyses, while the hypothesized models were tested using multiple regression analyses.

RESULTS

This study identified several areas of work-life and intrapersonal resources that impacted compassion satisfaction and compassion fatigue. Among Registered Nurses, compassion satisfaction was predicted by psychological capital, rewards, values and workload. Compassion fatigue was predicted by psychological capital, workload, control and community. Among licensed practical nurses, compassion satisfaction was predicted by psychological capital and emotional intelligence. Compassion fatigue was predicted by workload and psychological capital. Study results also revealed significant differences in Registered Nurses' and licensed practical nurses' perceptions of workload, rewards and fairness at work, and both compassion satisfaction and compassion fatigue. Registered Nurses perceived their workload to be more manageable and perceived greater rewards and greater fairness at work than licensed practical nurses. Compassion fatigue was higher for Registered Nurses than licensed practical nurses, while compassion satisfaction was higher for licensed practical nurses than Registered Nurses. Future studies should investigate the nature and span of these differences to suggest relevant strategies to mitigate compassion fatigue and promote compassion satisfaction for each of these nursing roles.

CONCLUSION

The results of this study underscore the need to create nursing work environments that foster a manageable workload and positive social relationships, where nurses have professional autonomy, decision-making capacities and access to adequate resources to do their job effectively. The nursing work environment should also provide recognition of nurses' contributions and an alignment between personal and organizational values. Investments in the development and improvement of nurses' psychological capital and emotional intelligence should be prioritized since they are malleable and impactful intrapersonal resources on compassion satisfaction and compassion fatigue.

REPORTING METHOD

This study adhered to the STROBE guidelines.

PUBLIC CONTRIBUTION

A total of 406 nurses were involved in this study by answering a self-administered study survey.

Feasibility and acceptability of a culturally adapted psychological first aid training intervention (Preparing Me) to support the mental health and well-being of front-line healthcare workers in China: a feasibility randomized controlled trial

Background: Psychological first aid (PFA) training helps to prepare healthcare workers (HCWs) to manage trauma and stress during healthcare emergencies, yet evidence regarding its effectiveness and implementation is lacking.Method: A two-arm feasibility randomized controlled trial design was conducted in a Chinese tertiary hospital. Participants were randomly allocated to receive either a culturally adapted PFA training (the intervention arm) or psychoeducation (the control arm). Feasibility indicators and selected outcomes were collected.Results: In total, 215 workers who expressed an interest in participating in the trial were screened for eligibility, resulting in 96 eligible participants being randomly allocated to the intervention arm (n = 48) and control arm (n = 48). There was a higher retention rate for the face-to-face PFA training session than for the four online group PFA sessions. Participants rated the PFA training as very helpful (86%), with a satisfaction rate of 74.25%, and 47% reported being able to apply their PFA skills in responding to public health emergencies or providing front-line clinical care. Positive outcome changes were observed in PFA knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth. Their scores on depression, anxiety, stress, and burnout measures all declined. Most of these changes were sustained over 3 months (p < .05). Repeated measures analysis of variance found statistically significant interaction effects on depression (F2,232 = 2.874, p = .046, η p 2  = .031) and burnout (F2,211 = 3.729, p = .018, η p 2  = .037), indicating a greater reduction in symptoms of depression and burnout with PFA compared to psychoeducation training.Conclusion: This culturally adapted PFA training intervention was highly acceptable among Chinese HCWs and was feasible in a front-line care setting. Preliminary findings indicated positive changes for the PFA training intervention on knowledge, skills, attitudes, resilience, self-efficacy, compassion satisfaction, and post-traumatic growth, especially a reduction of depression and burnout. Further modifications are recommended and a fully powered evaluation of PFA training is warranted.

Feasibility of a 3-Minute Mindful Breathing Intervention for Enhancing Psychiatric Mental Health Nurses' Resilience During COVID: Findings From a 4-Week Pilot Study

COVID created a perfect storm of conditions leading to excessive and prolonged stress on already vulnerable nurses. This study examines the feasibility of enhancing psychiatric mental health nurses' (PMHNs') resilience by practicing a 3-minute mindfulness-based intervention. In this pilot study, we explored if PMHNs could be recruited and retained for intervention implementation, intervention acceptability, and measurement of any notable changes over the prescribed period. Study feasibility is reflected in high participant retention and increased postintervention resilience scores. Given the positive outcomes, a larger-scale study is warranted. Additional areas of opportunity include strategies for increasing participant uptake, and, due to limited acceptability feedback, the introduction of a usefulness scale.

Effects of compassion satisfaction and compassion fatigue on posttraumatic growth of psychiatric nurses: A cross-sectional study

AIMS

This study aimed to explore the effects of compassion satisfaction and compassion fatigue on the posttraumatic growth of psychiatric nurses.

BACKGROUND

Psychiatric nurses' prolonged and repeated exposure to trauma and complex situations in the work environment can lead to negative emotions such as compassion fatigue, but they also experience positive consequences such as posttraumatic growth, and the relationship between compassion fatigue and posttraumatic growth is not unclear.

METHODS

A total of 336 nurses from psychiatry departments of seven tertiary hospitals in Sichuan Province, China, were administered an online questionnaire. Participants were recruited through convenience sampling. The posttraumatic growth level was measured with the Simplified Chinese version of the Posttraumatic Growth Inventory. The Professional Quality of Life Scale-Chinese version was used to assess compassion satisfaction, burnout and secondary traumatic stress. T-test and one-way variance analysis, Pearson correlation analysis and hierarchical linear regression were used for data analysis. A STROBE checklist was used to guide the reporting of the research.

RESULTS

Psychiatric nurses' posttraumatic growth is at a low level, influenced by demographic and occupational factors, whereas compassion satisfaction, burnout and secondary traumatic stress are at a moderate level. Hierarchical regression analysis suggested that compassion satisfaction and secondary traumatic stress had a positive impact on posttraumatic growth, whereas burnout had a negative impact on posttraumatic growth.

CONCLUSIONS

Findings suggest that nursing managers should attach importance to the mental health of psychiatric nurses, improve compassion satisfaction, alleviate burnout and promote posttraumatic growth.

Social support, empathy and compassion fatigue among clinical nurses: structural equation modeling

BACKGROUND

Clinical nurses are at high risk for compassion fatigue. Empathy is a prerequisite for compassion fatigue, and social support is an important variable in the process of reducing individual stress. However, the role of social support in the relationship between empathy and compassion fatigue remains unclear. This study explored whether social support mediates the relationship between empathy and compassion fatigue among clinical nurses.

METHODS

A total of 992 clinical nurses were recruited through convenience sampling for a cross-sectional study in Central China. They completed the General Information Questionnaire, Perceived Social Support Scale, Professional Quality of Life Scale, and Jefferson Scale of Empathy. SPSS was used to conduct descriptive statistical analyses. Pearson's or Spearman's correlation analyses and AMOS were employed to build a structural equation model (SEM) to verify the mediating effect of social support on the relationship between empathy and compassion fatigue.

RESULTS

The results indicated that the standardized direct effect of empathy on compassion fatigue was 0.127, and the standardized indirect effect of empathy on compassion fatigue through social support was 0.136. The mediation effect ratio between empathy and compassion fatigue was 51.7%.

CONCLUSIONS

Our findings show that social support mediates the relationship between empathy and compassion fatigue among clinical nurses. This finding suggests that increasing nurses' social support can decrease the prevalence of compassion fatigue. Nursing managers should provide training related to flexibly adjusting empathy and educating nurses to establish effective social networks with family, friends, and colleagues to prevent compassion fatigue.

Finding the right words: A focus group investigation of nurses' experiences of writing diaries for intensive care patients with a poor prognosis

BACKGROUND

The overall purpose of diaries written during an intensive care stay is to help patients fill in memory gaps from the illness trajectory, which might promote long-term psychological recovery. Diaries have also been shown to benefit nurses in maintaining a view of the patient as a person in the highly technical environment and to promote reflection. There is a lack of research on how nurses might be affected by writing a diary for critically ill patients with a poor prognosis.

OBJECTIVES

The aim of this study was to investigate nurses' experience of writing diaries for intensive care patients with a poor prognosis.

METHODS

This study has a qualitative descriptive design and was inspired by the methodology of interpretive description. Twenty-three nurses from three Norwegian hospitals with a well-established practice of writing diaries participated in four focus groups. Reflexive thematic analysis was used. The study was reported according to the Consolidated Criteria for Reporting Qualitative Research checklist.

FINDINGS

The overarching theme resulting from our analysis was "Finding the right words". This theme represents the challenge of writing in view of the uncertainty of the patient's survival and of who would read the diary. It was important to strike the right tone with these uncertainties in mind. When the patient's life could not be saved, the purpose of the diary expanded to comforting the family. To put an extra effort into making the diary something special when the patient was dying was also a meaningful activity for the nurses.

CONCLUSIONS

Diaries may serve other purposes than helping patients to understand their critical illness trajectory. In cases of a poor prognosis, nurses adapted their writing to comfort the family rather than informing the patient. Diary writing was meaningful for the nurses in managing care of the dying patient.

Implementing Brief Mindfulness-Based Interventions to Reduce Compassion Fatigue

BACKGROUND

Nurses in surgical-trauma units are susceptible to compassion fatigue due to work-related stressors. Mitigating and preventing compassion fatigue are critical to supporting the health and well-being of surgical-trauma nurses.

LOCAL PROBLEM

During the COVID-19 pandemic, a surgical-trauma unit was converted to a designated COVID-19 unit. Nurses verbalized feelings of burnout and stress during the pandemic and did not have a mechanism to cope with work-related stress. This project evaluated the impact of brief mindfulness-based interventions on compassion fatigue.

METHODS

From February 2021 to March 2022, mindfulness champions led 5 minutes of mindfulness-based interventions, including meditation, deep breathing, and self-compassion exercises, during shift huddles. The Professional Quality of Life, version 5, questionnaire was used to evaluate preintervention and postintervention burnout, secondary traumatic stress, and compassion satisfaction. Paired-sample t tests were used to evaluate the results.

RESULTS

Twenty-nine of 34 nurses responded (85% response rate) with matched preintervention and postintervention questionnaires. All subscale scores showed significant improvement after intervention. The mean burnout subscale score decreased by 9.35% (P = .003), mean secondary traumatic stress subscale score decreased by 11.89% (P = .005), and mean compassion satisfaction subscale score increased by 6.44% (P = .03) after intervention.

DISCUSSION

After implementing brief mindfulness-based interventions in shift huddles, nurses reported reductions in elements of compassion fatigue (burnout and secondary traumatic stress). Nurses reported that adding brief mindfulness-based interventions to shift huddles helped them cope with work-related stress.

CONCLUSIONS

Brief mindfulness-based interventions can improve nurses' compassion satisfaction while reducing compassion fatigue measurements.

Professional quality of life and its associated factors among Vietnamese doctors and nurses

BACKGROUND

Prevalence of health workers with occupational health issues ranked fourth among all careers resulting in a reduction in quality of life. However, tools to measure professional quality of life (ProQoL) are unavailable in Vietnamese. This study aims to develop a Vietnamese version of the ProQoL, and examine ProQoL and its associated factors among doctors and nurses.

METHODS

The ProQoL is comprised of 30 items measures compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS). The tool was translated into Vietnamese following the Guideline by Guillemin et. al (1993), reviewed by expert panels, and validated for internal consistency and test-retest reliability among 38 health workers working at hospitals in HCMC. The validated tool was then used in a cross-sectional study to measure the ProQoL of full-time doctors and nurses working in clinical departments at the University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam. In addition to the ProQoL, self-reported data about demographic and occupational characteristics were collected.

RESULTS

The Vietnamese version of ProQoL achieved high internal consistency (alphas between 0.85 and 0.91) and Intra-class Correlation Coefficients (ICCs between 0.71 and 0.89) for all subscales. Among 316 health workers, mean scores of CS, BO, STS were 36.4 (SD = 5.4), 24.9 (SD = 5.1), 25.9 (SD = 5.3), respectively, indicating moderate levels of CS, BO and STS. Participants who were older (b = 0.17, 95%CI = 0.08, 0.26), had sufficient perceived income (b = 2.59, 95%CI = 0.93, 4.24), and > 10 years of working experience (b = 2.15, 95%CI = 0.68, 3.62), had higher CS scores. Those who were older (b=-0.15, 95%CI=-0.23, -0.07), had sufficient perceived income (b=-2.64, 95%CI=-4.18, -1.09), > 10 years of experience (b=-1.38, 95%CI=-2.76, -0.01), worked in surgical department (b=-1.46, 95%CI=-2.54, -0.38) and 8 hours/day (b=-1.52, 95%CI=-2.61, -0.44), had lower BO scores. Moreover, those in a relationship (b=-2.27, 95%CI=-3.53, -1.01) and had sufficient perceived income (b=-1.98, 95%CI=-3.64, -0.32) had lower STS scores.

CONCLUSIONS

The Vietnamese version of ProQoL is valid and reliable for use among Vietnamese health workers. Age, marital status, perceived income status, years of working experience, daily working hours, and specialty was associated with at least one component of ProQoL but gender, religion, education level, and monthly income were not.

Do nurses' personality traits affect the level of compassion fatigue?

AIMS

To determine whether nurses' personality traits impact their levels of compassion fatigue.

BACKGROUNDS

Compassion fatigue has become one of nursing literature's most discussed and investigated topics. Although some nurses working in the same environment and under similar conditions are more resistant to compassion fatigue, some are at risk of it.

METHODS

This descriptive study was conducted with 451 nurses selected using a simple random sampling method in Turkey. Data were collected using web-based online survey forms between February and April 2022. A questionnaire form regarding personal traits and professional characteristics, the Compassion Fatigue-Short Scale, and Basic Personality Traits Inventory were used to collect the data. The data were analyzed with descriptive statistics, t-test, Pearson correlation, and multiple linear regression analysis.

RESULTS

The nurses' compassion fatigue was moderate, and personality traits were found to be agreeableness, conscientiousness, and extraversion, respectively. There was a negative correlation between compassion fatigue and personality traits of extraversion, conscientiousness, agreeableness, and openness to experience, yet a positive correlation with neuroticism and negative valence. According to the regression analysis, nurses' personality traits were effective on compassion fatigue by 21.9%. The personality trait of extraversion had a negative impact on compassion fatigue, and neuroticism had a positive impact.

CONCLUSION

This study identified a correlation between nurses' personality traits and compassion fatigue, suggesting that certain personality traits can be predictive factors of compassion fatigue. The limited number of studies discussing personality traits and compassion fatigue together increases the importance of the current study, which may shed light on future studies to be conducted on similar topics.

IMPLICATIONS FOR NURSING AND OTHER POLICIES

This study has important implications for nurse managers. Nurse managers can predict whether they may experience compassion fatigue based on their personality traits.

Stress impact of COVID-19 in nurse managers

Background

The COVID-19 pandemic has directly affected specially nurses, not only those on the front lines but also nurse managers.

Aims

To assess and compare stress levels of nurse managers before and during the pandemic, and to identify predictive factors.

Method

Cross-sectional studies were carried out in two moments, before and during pandemic. 102 manager nurses were recruited before the sanitary crisis (2018) and 87 during the health crisis (2020). Perceived stress was measured with the Perceived Stress Scale-14 and quality of professional life, job demands, motivation and managerial support were assessed with the Professional Quality of Life Questionnaire. Socio-demographic and job-related variables were also analysed. Statistical analysis was performed using student's t-test, correlations and multiple regression analysis.

Results

The majority of nurse managers were women, married, who worked the morning shift. 78.2% managed nursing personnel who worked with COVID patients. They suffered a significant increase in both job demands and perceived stress level in the pandemic. Job demands, working in shifts morning, being young and being unmotivated were predictors of perceived stress level according to multiple linear regression analysis.

Conclusion

Perceived stress was greatest during the COVID-19 pandemic. Both, before and during the pandemic, job demands are central predictors of nurse managers' general perceived stress. It is necessary to adapt the workplace to personal characteristics of the nurse manager and increase actions to enhance their motivation and reduce their job demands to prevent stress.

Development of a Moral Resilience Collaborative Program During a Pandemic

Elevated psychological stress can lead to moral distress affecting health care workers and organizations affecting patient care, job satisfaction, and retention. A Moral Resilience Collaborative program was implemented through an academic partnership between a school of nursing and a rehabilitation facility to provide the health care workers in the facility the skills necessary for self-management of moral distress and move them toward moral resilience. Moral distress and resiliency were measured pre-implementation using the Measure of Moral Distress for Healthcare Professionals (MMD-HP) and Short Resiliency Survey (SRS), respectively. Unfortunately, postsurvey quantitative data collection failed due to COVID-19 surges though qualitative data obtained during debriefing sessions demonstrated effectiveness of the project. Based on debriefing comments and the preimplementation MMD-HP mean score and SRS decompression score, the staff in this facility experienced similar types of moral distress as those working in acute care or critical care settings. Even when resiliency programs are needed the most and readily available, patient care demands, a busy work environment, and external factors can hinder staff participation in such endeavors.

The Impact of Loving-Kindness Meditation on Compassion Fatigue of Nurses Working in the Neonatal Intensive Care Unit: A Randomized Clinical Trial Study

Compassion fatigue is a common complication in nurses, which can lead to burnout, job dissatisfaction, and a decline in the quality of patient care. This study aimed to investigate the impact of loving-kindness meditation on compassion fatigue of nurses working in the neonatal intensive care unit (NICU). This cluster-blinded randomized clinical trial study was conducted on 66 NICU nurses in 2 educational hospitals selected. The intervention group received a 1-month online program for daily training and practice of loving-kindness meditation. The control group received miscellaneous files on mental health during the COVID-19 pandemic period. The Nursing Compassion Fatigue Inventory (NCFI) was filled out by the 2 groups, before and after the intervention. The results showed that the mean scores of the NCFI in the intervention group decreased significantly compared with before the intervention (P = .002). In comparison with the control group, there was a significant difference between the mean scores of the 2 groups after the intervention (P = .034). Among nurses working in NICU, loving-kindness meditation significantly reduces compassion fatigue after 1 month. These findings support the use of this intervention for nurses.

Compassion fatigue in nurses caring for chronic diseases

Objectives. The purpose of this study was to determine the level of compassion fatigue in nurses caring for chronic diseases and the factors that affect it. Nurses who provide continuous care for chronic diseases are under the risk of facing compassion fatigue. Methods. The descriptive and cross-sectional study took place during January-March 2019. The nurse identification form and the 'compassion fatigue' sub-dimension of the professional quality of life scale were used to determine compassion fatigue. Results. Nurses experience compassion fatigue at a moderate level. Female nurses, those who experience a decrease in their willingness to provide care and those who intend to leave work experience compassion fatigue more. Decrease in the willingness to provide care plays a determinant role on compassion fatigue. Nurses who experience compassion fatigue are unwilling to provide care to their patients. Conclusion. This study indicates the importance of the necessity for development of a compassion fatigue prevention program in the clinical area. Nurses should be trained on compassion fatigue within the scope of in-service training. This subject should be included in the school curriculum to increase the awareness of nursing students' about compassion fatigue.

Mediating effect of resilience between social support and compassion fatigue among intern nursing and midwifery students during COVID-19: a cross-sectional study

AIMS

To examine the mediating effect of resilience between social support and compassion fatigue among intern nursing and midwifery students during COVID-19.

BACKGROUND

Compassion fatigue has become exceedingly common among intern nursing and midwifery students, especially during the COVID-19 pandemic. Social support and resilience can help intern nursing and midwifery students control their negative emotions, reduce compassion fatigue, and increase their well-being. However, the mediating effect of resilience between social support and compassion fatigue remains unclear.

DESIGN

A multicentre cross-sectional survey.

METHODS

A total of 307 intern nursing and midwifery students were recruited from November 2020 to February 2021 in tertiary grade A hospitals in China. Structural equation modelling was applied to analyse the mediating effects of resilience between social support and compassion fatigue. The Social Support Rating Scale, the 10-item Connor-Davidson Resilience Scale, and the Chinese version of the Compassion Fatigue Short Scale were used to collect data. The hypothetical path model was tested by using IBM SPSS version 26.0 and AMOS version 26.0 software.

RESULTS

Intern nursing and midwifery students had moderate compassion fatigue. Social support positively affected resilience (β = 0.514, p < 0.01). Social support negatively affected compassion fatigue (β = - 0.310, p < 0.01), while resilience negatively affected compassion fatigue (β = - 0.283, p < 0.01). Resilience played a mediating role between social support and compassion fatigue.

CONCLUSION

Social support can directly affect the compassion fatigue of intern nursing and midwifery students during COVID-19 and indirectly through resilience. Stronger resilience can reduce compassion fatigue. Accordingly, resilience-based interventions should be developed to reduce compassion fatigue.

Compassion, emotions and cognition: Implications for nursing education

Compassion is often understood as central to nursing and as important to ensure quality nursing and healthcare. In recent years, there has been a focus on strategies in nursing education to ensure compassionate nurses. However, it is not always clear how the concept of compassion is understood. Theoretical conceptualisations that lie behind various understandings of compassion have consequences for how we approach compassion in nursing education. We present some ways in which compassion is often understood, their philosophical underpinnings and the consequences these understandings can have for nursing education. We argue that it is useful for nursing education to understand compassion as a cognitive emotion and discuss how such an understanding can inform educational approaches to compassion.

The Cost of Caring: Compassion Fatigue among Peer Overdose Response Workers in British Columbia

Background: The drug toxicity crisis has had dramatic impacts on people who use drugs. Peer overdose response workers (peer responders), i.e., individuals with lived/living experience of drug use who work in overdose response settings, are particularly susceptible to negative physical and mental health impacts of the crisis. Despite that, the mental health impacts on peer responders have yet to be studied and measured. Methods: The Professional Quality of Life survey (Version 5) was completed by 47 peer responders at two organizations in British Columbia between September 2020 and March 2021 to assess compassion satisfaction and compassion fatigue. The Likert scale responses were converted into numerical values and scores were calculated for each sub-scale. The mean score was calculated for each sub-scale and categorized as low, medium, or high, based on the instructions for Version 5 of the instrument. Results: Our study uncovered a high mean score for compassion satisfaction, low mean score for burnout, and medium mean score for secondary traumatic stress among peer responders. These results may be due to the participants' strong feelings of pride and recognition from their work, as well as the low number of participants that felt they had too much to do at work. Conclusion: Although peer responders derive pleasure and fulfillment from their jobs, i.e., compassion satisfaction, they also sometimes face burnout and stress due to continuous exposure to the trauma of the people they support. These results shed light on the areas that need to be targeted when creating supports for peer responders.

Assessment of Professional Quality of Life Among Critical Care Nurses During the COVID-19 Pandemic in Saudi Arabia

Aim

Nurses play a major role in critical care units (CCUs), providing care to critically ill patients while also facing numerous health challenges that impair their quality of life. This was especially evident during the COVID-19 pandemic. The aim of this study was to assess the professional quality of life (ProQOL) and establish the prevalence of compassion satisfaction and compassion fatigue among CCU nurses in Saudi Arabia.

Methods

A cross-sectional survey of CCU nurses was conducted using the ProQOL Scale, consisting of three subscales: 1) compassion satisfaction and compassion fatigue, 2) burnout, and 3) secondary traumatic stress. The data were analyzed to obtain descriptive and inferential statistics.

Results

A total of 238 ICU nurses, who were predominantly female (83%) and had a bachelor’s degree (80%), participated in this study. The ProQOL subscales exhibited varied mean scores across demographic variables. Statistically significant differences were observed in the compassion satisfaction (p=0.014) of CCU nurses working in public hospitals, and in the secondary traumatic stress (p=0.006) among nurses working in night shifts. The percentage distribution of CCU nurses’ individual levels for all the ProQOL subscales were within the average to high levels.

Conclusion

The ProQOL was significantly affected by the COVID-19 pandemic. Furthermore, varied ProQOL mean scores across demographic characteristics suggest that interpersonal differences should be considered when developing improvement initiatives.

The effect of a nurse-led intervention program on compassion fatigue, burnout, compassion satisfaction, and psychological distress in nurses: A randomized controlled trial

PURPOSE

This study evaluated the effect of a nurse-led intervention program on compassion fatigue, burnout, compassion satisfaction, and psychological distress in nurses.

DESIGN AND METHODS

A randomized controlled trial was conducted. A total of 48 clinical nurses were randomly allocated to intervention or control groups. The nurse-led intervention program was based on a cognitive-behavioral approach. The study outcomes were compassion fatigue, burnout, compassion satisfaction, and psychological distress.

FINDINGS

It was determined that the psychological distress scores of the nurses participating in the program at the first follow-up were significantly lower than the control group. There was no significant difference between the groups in terms of compassion fatigue, burnout, and compassion satisfaction.

PRACTICAL IMPLICATIONS

To reduce the psychological distress of nurses, cognitive behavioral approach-based programs can be useful.

Mental health nurses' constructions of compassion: A discourse analysis

Compassion is an important element of contemporary nursing work. Compassion has been recognized as necessary for improving health outcomes. However, very little is known about how compassion is understood in the mental health practice setting. We conducted interviews with seven mental health nurses to explore their perspectives on compassion and views on compassion policy. Analysis of the data revealed that compassion was identified and discussed as Compassion as part of the person (and the profession); Compassion: Fundamental to the nursing role; Barriers to compassion; Perspectives on compassion policy. In addition, findings demonstrated ethical constraints on compassion in the mental health context, as well as the administrative burden on nurses more broadly, which was also a reported barrier to compassion. Mental health nurses identified compassion as fundamental to their clinical practice, yet compassion was impeded owing to practical and emotional constraints upon nurses. System-wide action must be taken to increase and support the mental health nursing workforce to strengthen the practice of compassion. This will be fundamental to improving health outcomes that are claimed to be enhanced by compassion. This study is reported according to the COREQ guidelines.

Nursing Students and the Human Body: Application of an Ethics Pilot Project

This manuscript offers findings from a pilot project which prepares nursing students for embodied professional practice through the lens of ethics. Four undergraduate nursing students were mentored by two nursing faculty in the Dundon-Berchtold Institute Faculty Fellowship Program in the Application of Ethics through an exploration on the ethics of embodiment using an arts pedagogy across one academic year. Inspired by the intersection of nature and health, this project explores the impact of an arts-integrated pedagogy on the human body. The findings from this project provide a natural first step for nursing students to consider multiple interpretations of the human body and to facilitate the students' development of an embodied ethical practice that is perceptive, empathic, and attuned to themselves as natural beings as well as diverse individuals and populations. The findings from this pilot project presents a pivotal opportunity to guide future nursing curricular development toward holistic, nature-inspired, and mindful-based interventions in order to increase resilience, decrease risk factors of compassion fatigue and burnout, and support nursing students to develop strength-based skills to use in their professional nursing practice.

Childhood adversity and later life prosocial behavior: A qualitative comparative study of Irish older adult survivors

Objective

Although childhood adversity can have lasting effects into later life, positive adaptations have also been observed, including an increased tendency toward prosocial behavior. However, little is known about the link between childhood adversity and later life prosocial behavior, with a particular scarcity of research on intrafamilial childhood adversity. Therefore, this study aimed to examine older adult's experiences of childhood adversity and identify mechanisms linked to prosocial behavior. Two adversity contexts (intrafamilial and extrafamilial) were compared to explore individual, as well as broader cultural and contextual mechanisms linking childhood adversity and later life prosocial behavior.

Method

Semi-structured interviews (60–120 min) were conducted with N = 29 Irish (older) adult survivors of childhood adversity: n = 12 intrafamilial survivors (mean age: 58 years, range: 51–72), n = 17 institutional survivors (mean age: 61 years, range: 50–77). Interviews were analyzed using the framework analysis method, with reference to the conceptual model of altruism born of suffering.

Results

Five themes were identified on prosocial mechanisms, with three themes in both survivor groups (enhanced empathy, self-identity, amelioration), and two group-specific themes (compassion fatigue in intrafamilial survivors; denouncing detrimental social values in institutional survivors).

Conclusion

Results identified motivational processes and volitional factors linked to later life prosocial behavior. Connections to caring roles, (lack of) support, and social norms in childhood, as well as the need for a sense of purpose and meaning from the adversities in adulthood, highlight potential targets for psychotherapeutic intervention to promote prosocial responding and positive adaptation for childhood adversity survivors.

The Effects of Motivational Messages Sent to Emergency Nurses During the COVID-19 Pandemic on Job Satisfaction, Compassion Fatigue, and Communication Skills: A Randomized Controlled Trial

INTRODUCTION

During the COVID-19 pandemic, emergency nurses have been adversely affected physically, socially, and psychologically by factors such as increased workload, longer working hours, isolation from family, and limited resources. This study aimed to investigate the effect of motivational messages sent to emergency nurses during the COVID-19 pandemic on their job satisfaction, compassion fatigue, and communication skills.

METHODS

This was a randomized controlled experimental study. The study was conducted with 60 emergency nurses in 2 training and research hospitals in Istanbul between July 31 and August 31, 2021. The participants were randomly assigned to the intervention and control groups. Participants in the intervention group (n = 30) received daily motivational messages to their mobile phones by short message service for 21 days; those in the control group (n = 30) received no motivational messages. The Job Satisfaction Scale, Compassion Fatigue Scale, and Communication Skills Scale were administered before and after the intervention.

RESULTS

The mean age was 29.8 (SD = 7.5) and 28.7 years (SD = 6.9) in the intervention and control groups, respectively. Before the intervention, there were no significant differences in the groups' scores for job satisfaction (P = .561), compassion fatigue (P = .687), or communication skills (P = .355). After the intervention, the intervention group had significantly higher scores for job satisfaction (P < .001) and communication skills (P < .001) and significantly lower compassion fatigue scores than the control group (P < .001).

DISCUSSION

Our results suggest that motivational messages sent to emergency nurses during the COVID-19 pandemic increase job satisfaction and improve communication skills while reducing compassion fatigue.

Compassion fatigue in mental health nurses: A systematic review

WHAT IS KNOWN ON THE SUBJECT?: Compassion fatigue is the result of the unique stressors inherent in caregiving work, leading to a loss of compassion in clinical practice that may result in negative outcomes for mental healthcare consumers. Compassion fatigue has clear emotional and physical costs and significant impacts on staff recruitment and retention. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This review is the first to evaluate the quantitative literature on compassion fatigue in mental health nurses. Research on compassion fatigue in mental health nurses does not accurately account for the unique care relationship between nurse and consumer. Competency-based education, strong mental health nurse leadership, positive organizational cultures, clinical supervision and reflection alongside individual self-care strategies may mitigate compassion fatigue. WHAT ARE THE IMPLICATIONS FOR FUTURE PRACTICE?: Resources are urgently needed for education and workforce development that addresses compassion fatigue in mental health nurses. Interventions addressing the physical, cognitive and emotional demands of care work are needed to ensure mental health nurses have the capability to provide sustainable compassionate care to consumers. ABSTRACT: Introduction Although compassionate care is an essential component of mental health nursing, understandings of the impact of compassion fatigue is poorly understood. Aims/Questions To examine and synthesize available data on the prevalence of compassion fatigue within mental health nurses and consider what variables impact compassion fatigue. Method A search of MEDLINE, EMBASE, PsychINFO, Emcare, Web of Science, Scopus, CINAHL and grey literature for articles published between 1992 and February 2021 was conducted. Data were extracted from articles meeting inclusion criteria and integrated using narrative synthesis. Results Twelve articles were included. Prevalence of compassion fatigue ranged from low to high. Variables were identified that may mitigate the risk of compassion fatigue. Strong leadership and positive workplace cultures, clinical supervision, reflection, self-care and personal well-being may protect mental health nurses against compassion fatigue. Discussion Future research is needed on mental health nurses lived experience of compassion fatigue and their understandings of compassion. Implications for Practice Interventions should focus on increasing awareness of compassion fatigue and building individual and organizational resilience. Both organizations and individuals should be aware of the role they play in maintaining the capacity and capability for mental health nurses to provide sustainable and compassionate mental healthcare.

The Impact of US Nurses' Personal Religious and Spiritual Beliefs on Their Mental Well-Being and Burnout: A Path Analysis

This study addresses the gap in the literature regarding the impact of nurses' personal religious and spiritual beliefs on their mental well-being and burnout. A model of the association between these factors was tested based on surveys of 207 nurses located in southeastern USA and analyzed to determine the association between religion/spirituality, mental well-being, and burnout. A path analysis supported a model in which, through its positive impact on mental well-being, religion/spirituality was negatively associated with emotional exhaustion and depersonalization and positively associated with personal accomplishment.

Compassion satisfaction and compassion fatigue in haematology cancer nurses: A cross‐sectional survey

Aim

This study aimed to investigate compassion satisfaction (CS) and compassion fatigue (CF) in haematology nurses and their associated factors.

Design

A cross‐sectional survey.

Methods

The survey was conducted on 336 haematology nurses from 21 hospitals in Sichuan, China. The CS and CF were assessed by the Professional Quality of Life Scale version 5. The CF was determined by burnout and secondary traumatic stress.

Results

Haematology nurses in China had moderate levels of CS and moderate‐to‐low CF. Better nursing competence of teaching/consultation and communication/coordination and the percentage of critically ill patients >60% predicted higher CS. The permanent nurse, better nursing competence of communication/coordination and specialized clinical practice predicted less burnout, while working >40 hr per week or more nurse‐patient conflict events predicted more burnout. In addition, working >40 hr per week, more nurse‐patient conflict events and having the need of psychological support predicted higher secondary traumatic stress.

Compassionate Nursing Care Model: Results from a grounded theory study

Compassion, as an indicator for quality care, is highly valued by patients and healthcare professionals. Compassionate care is considered a moral dimension of nursing practice and an essential component of high quality care. This study aimed to answer these questions: (1) What are the facilitators and barriers of providing compassionate nursing care in the clinical setting? (2) Which strategies do nurses use to provide compassionate care? (3) What is the specific model of compassionate care for the nursing context? A grounded theory approach was used in this study. A total of 21 nurses working in diverse clinical settings participated in the study. Purposive and theoretical sampling was used to select the participants. Data were collected by in-depth face to face interviews and analyzed by the constant comparative method. Ethical approval was gained from the Ethical Review Board of Tabriz University of Medical sciences. The analysis resulted in the development of three main themes: (a) contextual factors affecting compassionate care, (b) the compassionate care actions, and (c) the consequences of compassionate care. The main dimensions of compassionate care are demonstrated in a Compassionate Nursing Care Model. Nurses' ability on providing compassionate care is influenced by individual and organizational factors that may facilitate or inhibit this type of care. Leadership and nurse managers should remove the barriers which diminish the nurses' ability to provide compassionate care and support them to engage in compassionate care programs. Identifying and recruiting compassionate nurses, developing their compassionate capacity, and providing role models of compassion could improve the flourishing of person-centered and compassionate care in clinical settings. The Compassionate Nursing Care Model (CNCM) provides a model to guide nursing care and research.

A little goes a long way: Strategies to support nursing staff amid COVID-19

ABSTRACT

This article discusses the impact of staffing shortage on nurses' mental health, and outlines ways, including a successful rounder initiative, for nurse leaders and facilities to address nurses' stress and burnout.

The Experiences of Home Care Nurses in Regard to the Care of Vulnerable Populations: A Qualitative Study

Home care nurses have become the main references in home care for vulnerable patients. In patients' homes they offer comprehensive and continuous care to both the vulnerable population and their families. The aim of this qualitative study was to explore experiences and perspectives of home care nurses regarding the care of vulnerable patients in Spain. We conducted in-depth semi-structured interviews with 15 home care nurses working with a vulnerable population. From a data analysis, two themes and four subthemes emerged: (1) "barriers to providing home care to vulnerable populations", with the following subthemes: "the particularities of the patient and their home caregivers" and "perceived barriers for the involvement of home care nurses in the care"; and (2) "the emotional cost of home care" with the subthemes "home care is draining for caregivers" and "the impact of home care on the home care nurses". These findings show us that nurses face a number of difficulties in home care for vulnerable patients. The training of nurses in certain competencies and skills by the social health services would enhance the quality of care offered to these patients.

The effect of COVID-19 anxiety levels of healthcare professionals on the quality of working life and related factors

AIM

This study aims to determine the effect of COVID-19 anxiety levels of healthcare professionals on their working life quality.

METHOD

The sample of the descriptive, cross-sectional and correlational study consisted of healthcare professionals working in two university hospitals in western Turkey between May and July 2021. We used the "Personal Information Form, Coronavirus Anxiety Scale, and Working Life Quality Scale" as data collection tools. We used numbers and percentage calculations, arithmetic mean, median (25th-75th percentile), Mann-Whitney U test, Spearmen correlation analysis and Linear Regression analysis to analyse the data.

RESULTS

The mean score on the Quality of Life Scale of healthcare professionals was 3.74 ± 0.28, and the mean score on the Coronavirus Anxiety Scale (CAS) was 9.66 ± 6.06 (min. 0; max. 20). We found a negative and weakly significant relationship between the mean score of the CAS of healthcare professionals and the mean score of the employee quality of life scale. According to the results of the multiple linear regression analysis, we found the factors significantly affecting the anxiety states of healthcare professionals related to the Coronavirus are the quality of working life, age, sex and the state of caring for a patient with COVID-19.

CONCLUSION

As a conclusion of this study, it was determined that healthcare professionals experienced anxiety, and anxiety decreased as ages, working years and the number of children they have increased. In addition, it was determined that as the anxiety of healthcare professionals increased, the quality of working life decreased.

The effect of resilience and self-efficacy on nurses' compassion fatigue: A cross-sectional study

AIM

To measure the prevalence of compassion fatigue among Chinese clinical nurses and to examine the effects of resilience and self-efficacy on compassion fatigue.

DESIGN

A cross-sectional descriptive survey was conducted in accordance with the STROBE guidelines.

METHODS

Participants were recruited from three tertiary hospitals in central China from October 3 to December 15, 2019, using convenience sampling. Clinical nurses (n = 992) from different nursing departments completed the General Information Questionnaire, Professional Quality of Life Scale, Connor-Davidson Resilience Scale, and General Perceived Self-Efficacy Scale. Descriptive statistics, t-tests, one-way analysis of variance, Pearson or Spearman's correlation analyses, and multiple linear regression models were used.

RESULTS

Nurses experienced moderate levels of compassion fatigue (burnout and secondary traumatic stress). Resilience and self-efficacy were significantly negatively correlated with burnout but not with secondary traumatic stress. Linear regression analysis showed that resilience, self-efficacy, exercise, and physical conditions were the main predictors of burnout. Only physical conditions and marital status significantly predicted secondary traumatic stress.

CONCLUSION

Nurses are vulnerable to compassion fatigue in China. Resilience and self-efficacy significantly negatively predicted nurses' compassion fatigue. Physical conditions, healthy lifestyles, and social support are also important factors for compassion fatigue.

IMPACT

Our findings can be used to generate targeted intervention and coping strategies for nurses to improve their resilience and self-efficacy to alleviate compassion fatigue.

Going above and beyond: using nursing theories to explore volunteerism during the COVID-19 pandemic

Historically, nurses have volunteered to serve in wars and natural catastrophes. However, instead of a distant disaster, many nurses in the UK volunteered, working above and beyond, to assist their colleagues, local communities and health systems in the NHS during the peaks of the COVID-19 pandemic. Although the motivations and benefits to the community or self of volunteerism have been discussed in the literature, there is a paucity of literature and theoretical understanding from the field of nursing. Using a reflective and personal account of volunteering, this article aims to provide a better understanding of the concept of volunteerism in nursing. By exploring associated nursing theories from Jean Watson and Kristen Swanson, this article aims to illuminate and expand the knowledge base about nursing volunteerism. These nursing theories can frame the act of volunteerism and nursing and illustrate the interrelations of nursing theory and the practice of nursing volunteerism.

Trends in nursing burnout management in foreign studies (literature review)

This review provides a general foreign overview of the current understanding and  prevalence of professional burnout among medical workers and summarizes the emerging trends in the management of the organization of work of nurses, preventing burnout, and an analysis of practices aimed at preventing burnout. Burnout negatively affects both mental and physical health, as well as increases economic losses and employee turnover.

Burnout depends on factors such as job satisfaction, professional rank, hospital level, gender, professional values, negative emotions, and core competencies.

Burnout syndrome is closely related to compassion fatigue syndrome, compassionate gratification and is part of the broader concept of professional quality of life. Compassion refers to recognition, understanding, emotional resonance, empathic concern and tolerance for the suffering of others, and motivation and action in relationships to help others.

The analysis of foreign literature has shown the relevance of this problem and, first of all, for nurses. The peculiarities of the work of nurses lead to the fact that their burnout is higher than among other medical workers. Various approaches to the management of professional burnout have been proposed. Burnout management can focus on the organization, the individual, or a combination of interventions.

When people have a positive belief system, work involvement, and access to many personal resources, they are less likely to experience stress and burnout.

Nursing burnout has worsened during the COVID-19 period and has exposed new pressing health issues. The COVID-19 pandemic has shown a shortage of nurses and has become a major problem in many countries.

The attitude of the community, the importance and the need for specialized and professional care, especially in situations of great difficulty and suffering, is important for medical personnel. Public sincere gratitude for the work of healthcare professionals will help build compassion for professionals who risk their lives to help people. 

Reliability and Validity of the Greek Version of the Professional Quality of Life Scale (ProQOL-V)

Background

Compassion constitutes a central element of all health and social care professions. The Professional Quality of Life Questionnaire is the most widely used instrument to measure compassion fatigue worldwide.

Objective

The aim of this study was to provide evidence for the reliability and the validity of ProQOL-V for Greece.

Methods

A total of 261 nurses selected by convenience sampling and required to complete the ProQOL and Secondary Traumatic Stress Scale (STSS). The reliability and validity of the scale was evaluated by correlation analysis, t-test, and confirmatory factor analysis.

Results

The overall Cronbach's a for Compassion Satisfaction was 0.87 ranging from 0.86 to 0.87 with individual items deleted, for Burn-out was 0.73 ranging from 0.71 to 0.79 with individual items deleted and for Secondary Traumatic Stress was 0.83 ranging from 0.81 to 0.84 with individual items deleted. Additionally, the Pearson correlation r for Compassion Satisfaction, Burn-out and Secondary Traumatic Stress showed strong correlations between test-retest measurements (p<0.001). Secondary Traumatic Stress and Burn-out were positively correlated to STSS as expected (r=0.69 for Secondary Traumatic Stress and r=0.57 for Burn-out) implying sufficient convergent validity. In contrast, Compassion Satisfaction was negatively correlated to STSS as expected (r=-0.25) implying sufficient divergent validity. Goodness-of-fit indices included TLI=0.856, CFI=0.895, and RMSEA=0.063 supporting the construct validity of the three-dimensional instrument.

Conclusion

ProQOL-V has good reliability and validity among nurses in Greece. The implications of relevant future research are important in relation to the health care management and the support and continuous education of front-line health and social care workers.

Work Environment Characteristics and Emotional Intelligence as Correlates of Nurses' Compassion Satisfaction and Compassion Fatigue: A Cross-Sectional Survey Study

This cross-sectional survey study examined the relationship between Canadian nurses' work environment characteristics, emotional intelligence, compassion fatigue and compassion satisfaction (n = 1271). Psychological demands, decision latitude, supervisor and coworker support, and emotional intelligence (EI) were significantly correlated with nurses' compassion satisfaction and compassion fatigue, except for two EI subscales. Furthermore, these relationships were stronger for compassion satisfaction than compassion fatigue, suggesting that they are influenced by different factors. Our results highlight the importance of creating reasonable psychological demands, empowering nurses to make decisions in their jobs, supportive relationships at work, and fostering the development of nurses' EI.

Prevalence and contextual factors associated with compassion fatigue among nurses in northern Uganda

BACKGROUND

Compassion fatigue is associated with negative consequences that undermine workplace performance. However, literature is scarce on compassion fatigue among nurses in the context of Uganda who are at higher risk of compassion fatigue owed to the nature of their occupation and the unfavorable work environment. We aimed to assess the prevalence and predictors of compassion fatigue among nurses in Northern Uganda.

METHODS

We conducted a cross-sectional survey among 395 randomly selected nurses from two referral and four general hospitals in Northern Uganda. Data was collected using a self-administered questionnaire. Data analysis consisted of descriptive statistics, cross-tabulations, and logistic regression at a 95% level of significance in SPSS version 25.

RESULTS

Of 395 nurses who took part in the study, 58.2% were female, 39.8% had a diploma, 47.1% were single, and 32.4% had worked for between 11-15 years. Close to 50% of the nurses experienced compassion fatigue. The predictors of compassion fatigue among the participants were; workplace bullying (AOR: 3.83; 95% CI: 1.99-7.36; p = <0.001) career enhancement opportunities (AOR: 9.16; 95% CI: 2.32-36.22; p = 0.002; and remuneration (AOR: 7.30; 95% CI: 2.73-19.49; p = <0.001).

CONCLUSION

More than 3 in 4 nurses in Northern Uganda experience compassion fatigue. The Ministry of Health together with other stakeholders should strive to increase career enhancement opportunities for nurses, improve nurses' remuneration and improve the overall workplace environment to prevent compassion fatigue among nurses in the country.